Audrey Smedley Virginia Commonwealth University
Brian D. Smedley Institute of Medicine
Race as Biology Is Fiction, Racism as a Social
Problem Is Real
Anthropological and Historical Perspectives on the Social
Construction of Race
● African Americans and Hispanics tend to receive
lower quality health care across a range of disease
areas (including cancer, cardiovascular disease,
HIV/AIDS, diabetes, mental health, and other
chronic and infectious diseases) and clinical services
(B. D. Smedley et al., 2003);
● African Americans are more likely than Whites to
receive less desirable services, such as amputation
of all or part of a limb (Gornick et al., 1996);
● Disparities are found even when clinical factors,
such as stage of disease presentation, comorbidities,
age, and severity of disease are taken into account
(B. D. Smedley et al., 2003);
● Disparities are found across a range of clinical settings,
including public and private hospitals, teaching
and nonteaching hospitals, and so forth (B. D.
Smedley et al., 2003);
● Disparities in care are associated with higher mortality
among minorities who do not receive the same
services as Whites (e.g., surgical treatment for
small-cell lung cancer; Bach, Cramer, Warren, &
Begg, 1999).
Several studies demonstrate significant racial differences
in the receipt of appropriate cancer diagnostic tests
(e.g., McMahon et al., 1999), treatments (e.g., Imperato,
Nenner, &Will, 1996), and analgesics (e.g., Bernabei et al.,
1998), while controlling for stage of cancer at diagnosis
and other clinical factors. Similarly, African Americans
with HIV infection are less likely than nonminorities to
receive antiretroviral therapy (Moore, Stanton, Gopalan, &
Chaisson, 1994), prophylaxis for pneumocystis pneumonia,
and protease inhibitors (Shapiro et al., 1999). These disparities
remain even after adjusting for age, gender, education,
CD4 cell count, and insurance coverage (e.g., Shapiro
et al., 1999).
Racial and ethnic discrimination
and disadvantage have been consistently documented in
studies of home mortgage lending (U.S. Department of
Housing and Urban Development, 1999), housing discrimination
and residential segregation (Massey, 2001), and
employment and housing practices (Fix, Galster, & Struyk,
1993).
contrary to the optimistic assessments of conservative thinkers
(DSouza, 1996; Thernstrom & Thernstrom, 1999) and,
more generally, the American public, race continues to play
an important role in determining how individuals are
treated, where they live, their employment opportunities,
the quality of their health care, and whether individuals can
fully participate in the social, political, and economic mainstream
of American life.
SwordOfMorningSuper Moderator
DKDetectiveBoo Boo Bubbles (he/him)
Lily Adler🎃 Happy Halloween! 💀
